About Celexa
Celexa is an antidepressant medication used for treating several
mood disorders. Celexa belongs to a group of antidepressant
drugs called SSRIs (selective serotonin reuptake inhibitor),
which are thought to work by increasing the amount of serotonin
(a chemical involved in communication between nerve cells)
available to the brain, so that it comes back to typical levels.
Low levels of serotonin are thought to be associated with
mood disorders, and high levels of serotonin appear to have
an antidepressant effect.
Celexa has been shown to be effective in relieving several
kinds of emotional disturbance that decrease the ability to
function normally, particularly depression. In low doses,
Celexa may be used to treat fibromyalgia.
Celexa may take several weeks to improve your condition, and
works best when taken regularly and at consistent times.
Celexa is currently prescribed as a medication for:
- Major depressive disorder (Celexa dosage 20-60 mg/day)
- Depression occurring after stroke (Celexa dosage 20 mg/day)
- Reduces frequency of tension headaches (Celexa dosage 20 mg/day)
- May assist recovery from alcohol abuse (Celexa dosage 40 mg/day)
- Obsessive compulsive disorder (Celexa dosage 20-40 mg/day)
- Premenstrual dysphoria syndrome (Celexa dosage 20 mg/day)
Celexa is only available by prescription.
Celexa Side Effects
Celexa side effects are usually temporary and can include the following,
based on a Celexa dosage of 20-60 mg/day.
Common Celexa Side Effects: Cough, diarrhea, dry mouth,
fatigue, insomnia, low blood pressure (may result in dizziness on
standing up), nausea, sweating, tremor, weight loss (minor). These
side effects typically appear early in treatment, and usually diminish
with continued use. If any of them persist, or are bothersome, speak
to your doctor. Other Celexa side effects occurred in less than
2% of patients compared with incidence of side effects for placebo.
Take care to avoid operating a vehicle or other heavy machinery
until you know how you react to Celexa. Celexa side effects may include
impaired thinking and motor skills, or cause blurred vision.
Cautions: Celexa should be used cautiously in patients with:
manic or bipolar disorders, blood circulation and metabolism difficulties,
or a history of seizures. Celexa may not be an appropriate medication
for patients with brain damage or disease, or congenital brain defects.
Celexa dosages should be lower for patients with kidney or liver
trouble. Tell your doctor if you have ever had an allergic reaction
to Celexa, to an antidepressant or anxiety medication of any type,
or any other medication.
Celexa Interactions
Celexa and alcohol have not been shown to interfere with
each other, but taking them together is not recommended. It's
possible that the combination may be hard on the liver.
Certain medications and supplements may increase the risk of serotonin
syndrome in combination with Celexa. Serotonin syndrome may cause
confusion, restlessness, lowered coordination, shivering or trembling,
diarrhea, fever, sweating, twitching, or behaving with an excitement
you can't control. If you experience a cluster of these symptoms,
and you suspect that it may be due to a drug interaction or overdose,
seek medical attention immediately. (This condition is very rare.)
Celexa interactions with the following drugs may be limited by following your doctor's advice. Always tell your doctor if you are taking any of the following:
- Anticonvulsants such as Cerebyx (fosphenytoin), Dilantin (phenytoin), Sinemet (carbidopa, levodopa),
or Tegretol (carbamazepine) may require patient monitoring when
used with Celexa.
- Appetite suppressants like Phentermine/Adipex
(fastin), Pondimin (fenfluramine), or Meridia
(sibutramine) may cause serious and dangerous side effects
in combination, do not combine these therapies.
- Azole antifungals such as Diflucan (fluconazole),
Nizoral (ketoconazole), or Sporanox (itraconazole),
may alter your heartbeat if used with Celexa.
- Benzodiazepines (a class of antidepressants, anti-panic agents,
and muscle relaxants) such as Ativan
(lorazepam), Valium (diazepam),
Halcion (triazolam), Restoril (temazepam), Librium(chlordiazepoxide),
Xanax (alprazolam),
Tranxene-SD (clorazepate), Paxipam (halazepam), ProSom (estazolam),
Klonopin (clonazepam)
should be used cautiously with Celexa.
- Beta Blockers - Drugs like Inderal
(propranolol), Lopressor (metoprolol), Tenormin (atenolol),
and others may build up in the body to toxic levels when combined
with SSRIs. Your doctor may
adjust dosages to compensate.
- BuSpar (buspirone) -
Do not combine.
- Calan (verapamil) - Increases blood levels of Celexa and increases
risk of serotonin syndrome.
- Cardizem (diltiazem) - Increases the risk of serotonin syndrome.
- Cough medicine (dextromethorphan) - Avoid combining.
- Coumadin (warfarin) - may cause bleeding problems when used
with Celexa. Your doctor may prevent this by adjusting the dosage
of one of these medications.
- Desyrel (trazodone) - Risk of Celexa
toxicity.
- Effexor (venlafaxine) - When used with Celexa, increases the
chance of developing the rare, but serious, side effect known
as serotonin syndrome.
- Gingko - May act as an MAO inhibitor, do not combine.
- Ginseng - May act as an MAO inhibitor, do not combine.
- Indian Snakeroot - Do not combine.
- Kava kava - Acts centrally in the nervous system, do not combine
with Celexa.
- Lanoxin (digoxin)
- Lithium (Eskalith) - Combine with caution, dosage adjustments
may be required.
- Macrolide antibiotics such as Azithromycin, Clarithromycin,
and Erythromycin, may increase Celexa levels in the blood.
- Ma Huang - Do not combine.
- MAO inhibitors - Celexa must never be mixed with MAO (monoamine
oxidase) inhibitors, a class of antidepressants and antisenility
drugs, such as Eldepryl (selegiline), Furoxone (furazolidone),
Nardil (phenelzine), Marplan (isocarboxazid), or Parnate (tranylcypromine).
Never use Celexa within 5-6 weeks of starting or stopping an
MAO inhibitor. This drug interaction could cause severe heart
problems or death. Patients over 65 should allow a longer wait
period between using Celexa and an MAO, as these medications may
stay in their system longer than in other patients.
- Migraine medications of the triptan class such as Amerge
(naratriptan), Imitrex
(sumatriptan), Maxalt (rizatriptan), or Zomig (zolmitriptan)
can cause coordination difficulties when mixed with SSRIs.
- Narcotic pain medication like Codeine, Demerol
(meperidine), Buprenex (buprenorphine), Darvon (propoxyphene),
Dilaudid (hydromorphone), MS Contin or Kadian (morphine), nalbuphine,
OxyContin (oxycodone),
Percocet (oxycodone and
acetaminophen), Stadol (butorphanol), Talwin compound (pentazocine),
Vicodin (hydrocodone and acetaminophen),
or Vicoprofen (hydrocodone and
ibuprofen) should be used cautiously with Celexa, as these
medications also act on the central nervous system.
- Quinaglute (quinidine)
- Rescriptor (delavirdine) - May lead to Celexa toxicity, avoid
this combination.
- Sedatives like Fioricet
(butalbital, acetaminophen, and caffeine), Fiorinal,
Phenobarbitol, Seconal, or other barbiturates.
- Selective serotonin reuptake inhibitors (SSRIs) of any other
type, like Paxil (paroxetine),
Prozac (fluoxetine), Luvox (fluvoxamine), or Zoloft (sertraline)
should not be mixed together.
- Sleep medication like Ambien
(zolpidem), Sonata (zaleplon),
or over the counter sleeping pills should be used with Celexa
only as, and if, advised by your doctor.
- St. John's Wort - May raise serotonin levels too high, do not
combine.
- Street drugs such as LSD, Ecstasy (MDMA), or marijuana. These
drugs also affect serotonin levels in the brain and may react
strongly with an SSRI like Celexa. These interactions have not
been studied in clinical tests and the side effects may prove
very dangerous.
- Tagamet (cimetidine)
- Tikosyn (dofetilide) - Your doctor may decrease your dose of
this medication to prevent increased blood levels.
- Tranquilizers such as Haldol (haloperidol) or Thorazine (chlorpromazine)
may cause oversedation.
- Tricyclic antidepressants such as Elavil
(amitriptyline), Asendin (amoxapine), Anafranil (clomipramine),
Pertofrane or Norpramin (desipramine), Sinequan
(doxepin), Tofranil (imipramine), Aventyl or Pamelor (nortriptyline),
Vivactil (protriptyline), and Surmontil (trimipramine), may increase
the risk of side effects from Celexa. The use of Celexa with Elavil,
Anafranil, or Tofranil can increase the chance of developing serotonin
syndrome.
- Tryptophan or 5-HTP (Contained in certain amino acid supplements
or by itself) - This supplement may increase the risk of serotonin
syndrome when mixed with Celexa.
- Ultram (Tramadol) - May increase
the risk of seizure, avoid this combination.
- Viagra (sildenafil)
- Wellbutrin/Zyban (bupropion)
Talk with your doctor if you are considering mixing an antidepressant
and anxiety medication like Celexa with any other antidepressant,
or any medication that may cause drowsiness. Anxiety medication
can have increased, unexpected, or severe side effects when mixed
with other medications that affect the central nervous system.
Celexa Dosages
Celexa is available as a tablet, or liquid. Your Celexa dosage should
be the least amount required to treat your symptoms.
- Celexa 10 mg, beige tablet
- Celexa 20 mg, pink scored tablet
- Celexa 40 mg, white scored tablet
- Celexa liquid, peppermint flavor, 2 mg/1mL. Shake well, store
below 77°F (25°C), but do not freeze.
Celexa dosages usually begin at 20 mg/day. The dosage may be stepped
up at a rate of 10 mg/week according to your doctor's advice. If
you are planning to stop taking Celexa, ask your doctor about reducing
your dose gradually. It is not usually recommended for patients
to stop Celexa all at once.
People with kidney or liver trouble, the elderly, or those with weak constitutions should take no more than 40 mg/day.
Maximum Celexa dosage should not exceed 60 mg/day. Celexa
overdose may cause coma, irritability, dizziness, drowsiness, racing
heartbeat, facial flushing, nausea, sweating, tremor, or vomiting,
and should be treated by a healthcare professional immediately.
Celexa Directions
Celexa is normally taken once a day, and can be taken with or without
food, except grapefruit juice. You should avoid grapefruit juice
while you are on Celexa, as it may lead to increased blood levels
of the drug. If you miss a dose, do not take a double dose the following
day.
Celexa should be stopped slowly, by gradually decreasing dosage
as directed by your doctor. Suddenly stopping Celexa treatment can
cause increased side effects.
Celexa should be stored away from heat and light. The oral solution
should not be allowed to freeze.
Celexa and Pregnancy
Celexa has not adequately been studied in humans for safety during
pregnancy. Celexa has been studied in animals, and shown to increase
the death and deformity rate in unborn animals at doses higher than
typically prescribed. Incidences of retarded growth were also reported.
Animal studies are not always predictive of results in humans, but
this medication is not generally recommended for pregnant women.
Advise your doctor if you are pregnant, or are planning a pregnancy
if you are considering taking Celexa. The manufacturer recommends
that Celexa be taken during pregnancy only if the benefit justifies
the possible risk to the fetus.
Similar precautions apply for breastfeeding, where some amount
of Celexa may pass to the child. Discuss the risks and benefits of
treatment with your doctor.
Celexa and Children
Celexa has not been studied for use in children.
Celexa and Seniors
Celexa has not been shown to have different side effects in the
elderly than in the general population, but it appears to stay in
the system longer. Patients 65 years or older should try a lower
starting dose of Celexa, with 20 mg/day being the recommended starting
amount, up to a maximum of 40 mg/day.
Celexa is a trademark of Forest
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This document is provided for information only. It is not a substitute for consultation with a physician, either to diagnose symptoms or prescribe treatment. Any dosages mentioned are general guidelines only, please follow the directions of your doctor or pharmacist exactly when taking medication. We have made every effort to ensure that this information is accurate, but only your doctor can say if a medication, or drug combination, is safe for you. Information intended for US residents only.
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